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Oxycodone prolonged release: a guide to its use in the EU

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Abstract

Oxycodone prolonged-release (PR) tablets provide a convenient twice-daily oral opioid option for the treatment of chronic pain, including cancer-related pain. Its analgesic efficacy in these settings has been established in clinical trials and extensive clinical practice and appears to be generally similar to that of oxycodone immediate release (IR) and long-acting oral formulations of other opioids. Oxycodone PR has a tolerability profile consistent with that of other opioids and is associated with less ‘drug liking’ and lower ‘drug highs’ than oxycodone IR when taken appropriately (i.e. as intact tablets, not crushed).

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References

  1. EFIC® EPF. Costs of chronic pain. 2015. http://www.efic.org/index.asp?sub=B47GFCF5J4H43I. Accessed 15 Dec 2015.

  2. World Health Organization. WHO’s cancer pain ladder for adults. 2015. http://www.who.int/cancer/palliative/painladder/en/index.html. Accessed 15 Dec 2015.

  3. WHO. Cancer pain relief: with a guide to opioid availability. 2nd ed. Geneva: World Health Organization; 1996.

  4. Leung L. From ladder to platform: a new concept for pain management. J Prim Health Care. 2012;4(3):254–8.

    PubMed  Google Scholar 

  5. Tetrault JM, Butner JL. Non-medical prescription opioid use and prescription opioid use disorder: a review. Yale J Biol Med. 2015;88(3):227–33.

    PubMed  PubMed Central  Google Scholar 

  6. Ripamonti CI, Santini D, Maranzano E, et al. Management of cancer pain: ESMO Clinical Practice Guidelines. Ann Oncol. 2012;23(Suppl 7):vii139–54.

  7. Caraceni A, Hanks G, Kaasa S, et al. Use of opioid analgesics in the treatment of cancer pain: evidence-based recommendations from the EAPC. Lancet Oncol. 2012;13(2):e58–68.

    Article  CAS  PubMed  Google Scholar 

  8. CHAMP (Collaboration for Home Care Advances in Management and Practice). Review of pharmacological pain management. http://www.champ-program.org/static/Review_WHOPainLadder_OpioidsandNonOpioids.pdf. Accessed 21 Dec 2015.

  9. Taylor R Jr, Raffa RB, Pergolizzi JV Jr. Controlled release formulation of oxycodone in patients with moderate to severe chronic osteoarthritis: a critical review of the literature. J Pain Res. 2012;5:77–87.

    CAS  PubMed  PubMed Central  Google Scholar 

  10. Rauck RL. What is the case for prescribing long-acting opioids over short-acting opioids for patients with chronic pain? A critical review. Pain Pract. 2009;9(6):468–79.

    Article  PubMed  Google Scholar 

  11. Olbete (oxycodone hydrochloride) prolonged-release tablets: summary of prescribing information (Portugal). Sintra: Tecnimede—Sociedade Técnico-Medicinal, S.A; 2014.

  12. Ordonez Gallego A, Gonzalez Baron M, Espinosa Arranz E. Oxycodone: a pharmacological and clinical review. Clin Transl Oncol. 2007;9(5):298–307.

  13. Schmidt-Hansen M, Bennett MI, Arnold S, et al. Oxycodone for cancer-related pain. Cochrane Database Syst Rev. 2015;2:Cd003870.

  14. Kaplan R, Parris WC, Citron ML, et al. Comparison of controlled-release and immediate-release oxycodone tablets in patients with cancer pain. J Clin Oncol. 1998;16(10):3230–7.

    CAS  PubMed  Google Scholar 

  15. Parris WC, Johnson BW Jr, Croghan MK, et al. The use of controlled-release oxycodone for the treatment of chronic cancer pain: a randomized, double-blind study. J Pain Symptom Manage. 1998;16(4):205–11.

    Article  CAS  PubMed  Google Scholar 

  16. Stambaugh JE, Reder RF, Stambaugh MD, et al. Double-blind, randomized comparison of the analgesic and pharmacokinetic profiles of controlled- and immediate-release oral oxycodone in cancer pain patients. J Clin Pharmacol. 2001;41(5):500–6.

    Article  CAS  PubMed  Google Scholar 

  17. Salzman RT, Roberts MS, Wild J, et al. Can a controlled-release oral dose form of oxycodone be used as readily as an immediate-release form for the purpose of titrating to stable pain control? J Pain Symptom Manage. 1999;18(4):271–9.

    Article  CAS  PubMed  Google Scholar 

  18. Bruera E, Belzile M, Pituskin E, et al. Randomized, double-blind, cross-over trial comparing safety and efficacy of oral controlled-release oxycodone with controlled-release morphine in patients with cancer pain. J Clin Oncol. 1998;16(10):3222–9.

    CAS  PubMed  Google Scholar 

  19. Heiskanen T, Kalso E. Controlled-release oxycodone and morphine in cancer related pain. Pain. 1997;73(1):37–45.

    Article  CAS  PubMed  Google Scholar 

  20. Mercadante S, Tirelli W, David F, et al. Morphine versus oxycodone in pancreatic cancer pain: a randomized controlled study. Clin J Pain. 2010;26(9):794–7.

    Article  PubMed  Google Scholar 

  21. Mucci-LoRusso P, Berman BS, Silberstein PT, et al. Controlled-release oxycodone compared with controlled-release morphine in the treatment of cancer pain: a randomized, double-blind, parallel-group study. Eur J Pain. 1998;2(3):239–49.

    Article  CAS  PubMed  Google Scholar 

  22. Riley J, Branford R, Droney J, et al. Morphine or oxycodone for cancer-related pain? A randomized, open-label, controlled trial. J Pain Symptom Manag. 2015;49(2):161–72.

    Article  Google Scholar 

  23. Hagen NA, Babul N. Comparative clinical efficacy and safety of a novel controlled-release oxycodone formulation and controlled-release hydromorphone in the treatment of cancer pain. Cancer. 1997;79(7):1428–37.

    Article  CAS  PubMed  Google Scholar 

  24. Imanaka K, Tominaga Y, Etropolski M, et al. Efficacy and safety of oral tapentadol extended release in Japanese and Korean patients with moderate to severe, chronic malignant tumor-related pain. Curr Med Res Opin. 2013;29(10):1399–409.

    Article  CAS  PubMed  Google Scholar 

  25. Silvestri B, Bandieri E, Del Prete S, et al. Oxycodone controlled-release as first-choice therapy for moderate-to-severe cancer pain in Italian patients: results of an open-label, multicentre, observational study. Clin Drug Investig. 2008;28(7):399–407.

    Article  CAS  PubMed  Google Scholar 

  26. Citron ML, Kaplan R, Parris WC, et al. Long-term administration of controlled-release oxycodone tablets for the treatment of cancer pain. Cancer Invest. 1998;16(8):562–71.

    Article  CAS  PubMed  Google Scholar 

  27. Liguori S, Gottardi M, Micheletto G, et al. Pharmacological approach to chronic visceral pain. Focus on oxycodone controlled release: an open multicentric study. Eur Rev Med Pharmacol Sci. 2010;14(3):185–90.

    CAS  PubMed  Google Scholar 

  28. Hale ME, Fleischmann R, Salzman R, et al. Efficacy and safety of controlled-release versus immediate-release oxycodone: randomized, double-blind evaluation in patients with chronic back pain. Clin J Pain. 1999;15(3):179–83.

    Article  CAS  PubMed  Google Scholar 

  29. Caldwell JR, Hale ME, Boyd RE, et al. Treatment of osteoarthritis pain with controlled release oxycodone or fixed combination oxycodone plus acetaminophen added to nonsteroidal antiinflammatory drugs: a double blind, randomized, multicenter, placebo controlled trial. J Rheumatol. 1999;26(4):862–9.

    CAS  PubMed  Google Scholar 

  30. Wild JE, Grond S, Kuperwasser B, et al. Long-term safety and tolerability of tapentadol extended release for the management of chronic low back pain or osteoarthritis pain. Pain Pract. 2010;10(5):416–27.

    Article  PubMed  Google Scholar 

  31. Afilalo M, Etropolski MS, Kuperwasser B, et al. Efficacy and safety of tapentadol extended release compared with oxycodone controlled release for the management of moderate to severe chronic pain related to osteoarthritis of the knee: a randomized, double-blind, placebo- and active-controlled phase III study. Clin Drug Investig. 2010;30(8):489–505.

    Article  CAS  PubMed  Google Scholar 

  32. Hale M, Tudor IC, Khanna S, et al. Efficacy and tolerability of once-daily OROS hydromorphone and twice-daily extended-release oxycodone in patients with chronic, moderate to severe osteoarthritis pain: results of a 6-week, randomized, open-label, noninferiority analysis. Clin Ther. 2007;29(5):874–88.

    Article  CAS  PubMed  Google Scholar 

  33. Portenoy RK, Farrar JT, Backonja MM, et al. Long-term use of controlled-release oxycodone for noncancer pain: results of a 3-year registry study. Clin J Pain. 2007;23(4):287–99.

    Article  PubMed  Google Scholar 

  34. Friedmann N, Klutzaritz V, Webster L. Long-term safety of Remoxy® (extended-release oxycodone) in patients with moderate to severe chronic osteoarthritis or low back pain. Pain Med. 2011;12(5):755–60.

    Article  PubMed  Google Scholar 

  35. Gatti A, Longo G, Sabato E, et al. Long-term controlled-release oxycodone and pregabalin in the treatment of non-cancer pain: an observational study. Eur Neurol. 2011;65(6):317–22.

    Article  CAS  PubMed  Google Scholar 

  36. Gatti A, Sabato AF, Occhioni R, et al. Controlled-release oxycodone and pregabalin in the treatment of neuropathic pain: results of a multicenter Italian study. Eur Neurol. 2009;61(3):129–37.

    Article  CAS  PubMed  Google Scholar 

  37. Hanna M, O’Brien C, Wilson MC. Prolonged-release oxycodone enhances the effects of existing gabapentin therapy in painful diabetic neuropathy patients. Eur J Pain. 2008;12(6):804–13.

    Article  CAS  PubMed  Google Scholar 

  38. Tessaro L, Bandieri E, Costa G, et al. Use of oxycodone controlled-release immediately after NSAIDs: a new approach to obtain good pain control. Eur Rev Med Pharmacol Sci. 2010;14(2):113–21.

    CAS  PubMed  Google Scholar 

  39. Ravera E, Di Santo S, Bosco R, et al. Controlled-release oxycodone tablets after transdermal-based opioid therapy in patients with cancer and non-cancer pain. Aging Clin Exp Res. 2011;23(5–6):328–32.

    Article  CAS  PubMed  Google Scholar 

  40. Rischitelli DG, Karbowicz SH. Safety and efficacy of controlled-release oxycodone: a systematic literature review. Pharmacotherapy. 2002;22(7):898–904.

    Article  CAS  PubMed  Google Scholar 

  41. Wiffen PJ, Derry S, Moore RA. Impact of morphine, fentanyl, oxycodone or codeine on patient consciousness, appetite and thirst when used to treat cancer pain. Cochrane Database Syst Rev. 2014;5:Cd011056.

  42. Wightman R, Perrone J, Portelli I, et al. Likeability and abuse liability of commonly prescribed opioids. J Med Toxicol. 2012;8(4):335–40.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  43. Webster LR, Bath B, Medve RA, et al. Randomized, double-blind, placebo-controlled study of the abuse potential of different formulations of oral oxycodone. Pain Med. 2012;13(6):790–801.

    Article  PubMed  Google Scholar 

  44. Chou R, Fanciullo GJ, Fine PG, et al. Clinical guidelines for the use of chronic opioid therapy in chronic noncancer pain. J Pain. 2009;10(2):113–30.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  45. Coluzzi F, Pappagallo M. Opioid therapy for chronic noncancer pain: practice guidelines for initiation and maintenance of therapy. Minerva Anestesiol. 2005;71(7–8):425–33.

    CAS  PubMed  Google Scholar 

  46. van Ojik AL, Jansen PA, Brouwers JR, et al. Treatment of chronic pain in older people: evidence-based choice of strong-acting opioids. Drugs Aging. 2012;29(8):615–25.

    Article  PubMed  Google Scholar 

  47. Gaskell H, Moore RA, Derry S, et al. Oxycodone for neuropathic pain and fibromyalgia in adults. Cochrane Database Syst Rev. 2014;6:Cd010692.

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Acknowledgments

The review was reviewed by: B. Claus, Ghent University Hospital, Ghent, Belgium; M. Hahn, Vitos Rheingau, Eltville, Germany; E. Obarcanin, Heinrich Heine University Düsseldorf, Düsseldorf, Germany. During the peer review process, Tecnimede (a manufacturer of oxycodone PR) was also offered an opportunity to review this article. Changes resulting from comments received were made on the basis of scientific and editorial merit.

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Correspondence to Katherine A. Lyseng-Williamson.

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The preparation of this review was not supported by any external funding.

Conflict of interest

E.D. Deeks and K.A. Lyseng-Williamson are salaried employees of Adis/Springer, are responsible for the article content and declare no conflicts of interest.

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Deeks, E.D., Lyseng-Williamson, K.A. Oxycodone prolonged release: a guide to its use in the EU. Drugs Ther Perspect 32, 363–368 (2016). https://doi.org/10.1007/s40267-016-0326-1

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